Healthcare professionals’ encounters with ethnic minority patients: The critical incident approach

ObjectiveThe purpose of this study is to examine workplace violence (WPV) towards healthcare professionals in a multiethnic area in China, including prevalence, influencing factors, healthcare professionals’ response to WPV, expected antiviolence training measures and content, and evaluation of WPV interventions.DesignA cross-sectional study.SettingA grade III, class A hospital in the capital of Yunnan Province, which is the province with the most diverse ethnic minority groups in China.ParticipantsIn total, 2036 healthcare professionals participated, with a response rate of 83.79%.ResultsThe prevalence of physical and psychological violence was 5.5% and 43.7%, respectively. Healthcare professionals of ethnic minority were more likely to experience psychological violence (OR=1.54, 95% CI 1.16 to 2.05). Stratified by gender, male healthcare professionals of ethnic minority suffered from more physical violence (OR=3.31, 95% CI 1.12 to 9.79), while female healthcare professionals suffered from psychological violence (OR=1.71, 95% CI 1.24 to 2.36). We also found a unique work situation in China: overtime duty on-call work (18:00–07:00) was a risk factor for psychological violence (OR=1.40, 95% CI 1.02 to 1.93). Healthcare professionals of ethnic minority are less likely to order perpetrators to stop or to report to superiors when faced with psychological violence. They are also more interested in receiving training in force skills and self-defence. Both Han and ethnic minority participants considered security measures as the most useful intervention, while changing the time of shift the most useless one.ConclusionOur study comprehensively described WPV towards healthcare professionals in a multiethnic minority area. More research on WPV conducted in multiethnic areas is needed.

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Mental well-being of patients from ethnic minority groups during critical care: a qualitative ethnographic study

BMJ Open ◽

10.1136/bmjopen-2016-014075 ◽

2017 ◽

Vol 7 (9) ◽

pp. e014075 ◽

Cited By ~ 4

Author(s):

Rose Lima Van Keer ◽

Reginald Deschepper ◽

Luc Huyghens ◽

Johan Bilsen

Keyword(s):

Mental Health ◽

Risk Factors ◽

Critical Care ◽

Ethnic Minority ◽

Healthcare Professionals ◽

Minority Groups ◽

Mental Health Problems ◽

Well Being ◽

Ethnic Minority Groups ◽

Mental Well Being

ObjectivesTo investigate the state of the mental well-being of patients from ethnic minority groups and possible related risk factors for the development of mental health problems among these patients during critical medical situations in hospital.DesignQualitative ethnographic design.SettingOneintensive care unit (ICU) of a multiethnic urban hospital in Belgium.Participants84 ICU staff members, 10 patients from ethnic-minority groups and their visiting family members.ResultsPatients had several human basic needs for which they could not sufficiently turn to anybody, neither to their healthcare professionals, nor to their relatives nor to other patients. These needs included the need for social contact, the need to increase comfort and alleviate pain, the need to express desperation and participate in end-of-life decision making. Three interrelated risk factors for the development of mental health problems among the patients included were identified: First, healthcare professionals’ mainly biomedical care approach (eg, focus on curing the patient, limited psychosocial support), second, the ICU context (eg, time pressure, uncertainty, regulatory frameworks) and third, patients’ different ethnocultural background (eg, religious and phenotypical differences).ConclusionsThe mental state of patients from ethnic minority groups during critical care is characterised by extreme emotional loneliness. It is important that staff should identify and meet patients’ unique basic needs in good time with regard to their mental well-being, taking into account important threats related to their own mainly biomedical approach to care, the ICU’s structural context as well as the patients’ different ethnocultural background.

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What is the role of cultural competence in ethnic minority consumer engagement? An analysis in community healthcare

International Journal for Equity in Health ◽

10.1186/s12939-019-1104-1 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Reema Harrison ◽

Merrilyn Walton ◽

Ashfaq Chauhan ◽

Elizabeth Manias ◽

Upma Chitkara ◽

...

Keyword(s):

Cultural Competence ◽

Ethnic Minority ◽

Healthcare Professionals ◽

Consumer Engagement ◽

Quality Health Care ◽

Community Healthcare ◽

Individual Interviews ◽

System Service ◽

Quality Health

Abstract Background Effective patient engagement has been associated with high quality health care. There is a dearth of evidence around effective engagement with consumers from ethnic minority backgrounds; specifically in relation to the role of cultural competence amongst healthcare professionals in effective engagement with consumers from ethnic minority backgrounds. To address this knowledge gap, we analysed the role of cultural competence in the consumer engagement approaches taken by community healthcare professionals working with consumers from ethnic minority backgrounds. Methods Semi-structured individual interviews were conducted with 21 healthcare professionals employed across four community healthcare and affiliated services in four local government areas in Australia. Results Adopting patient-centric approaches (that seek to understand and be responsive to the patient as an individual) featured as an underpinning theme that transcended other emerging themes. Recognition of diversity within communities and individuals in those communities, all with their own story, was described as pivotal to effective engagement. This was encapsulated in the theme of Cultural standpoints and personal context that contained four further themes of: (1) Build foundations of trust and respect; (2) Diversify communication channels; (3) Generate system, service and community partnerships; (4) Take the time. Conclusion Our findings indicate that cultural competence and effective consumer engagement are closely linked in ethnic minority populations. Embedding cultural competence as a health system, service and professional capability is therefore critical to ensure equitable healthcare quality for consumers from all ethnic backgrounds.

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Coping Strategies of Norwegian Healthcare Professionals Facing Perinatal Death—A Qualitative Study

International Journal of Childbirth ◽

10.1891/ijcbirth-d-19-00019 ◽

2019 ◽

Vol 9 (3) ◽

pp. 107-119 ◽

Cited By ~ 1

Author(s):

Beate André ◽

Raija Dahlø ◽

Tina Eilertsen ◽

Ingegerd Hildingsson ◽

Shefaly Shorey ◽

...

Keyword(s):

Coping Strategies ◽

Critical Incident ◽

Healthcare Professionals ◽

Perinatal Death ◽

Structured Interview ◽

Public Hospitals ◽

Healthcare Personnel ◽

Sharing Responsibility ◽

Assistant Nurses ◽

Appropriate Education

AIMPerinatal death is often regarded as a critical incident for the healthcare personnel involved. How healthcare personnel respond to traumatic events in their work is a function of their level of awareness or exposure to the incident, as well as their genuine expectations, support, and trust. The aim of this study was to explore coping strategies of Norwegian healthcare professionals including midwifes, obstetricians, and assistant nurses when faced with perinatal death in a clinical setting.METHODMidwives, obstetricians, and assistant nurses in two public hospitals in Norway participated in an in-depth and semi-structured interview. The data was analyzed using Kvale's approach, which involves condensing and thematic analysis.FINDINGSThe results are divided into three categories with eight subcategories. Having the support of one's colleagues was described as an important factor for coping with these situations. Both immediate support in the situation and talking about their feelings later with colleagues were found to be important. Discussing and sharing responsibility were also mentioned.CONCLUSIONInformants in this study stated that talking with one another about the challenges they faced in these situations was important. Appropriate education and training programs, together with healthy coping and debriefing strategies must be implemented in maternity units.

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Diversity training for psychiatrists

Advances in Psychiatric Treatment ◽

10.1192/apt.11.3.159 ◽

2005 ◽

Vol 11 (3) ◽

pp. 159-167 ◽

Cited By ~ 27

Author(s):

Nisha Dogra ◽

Khalid Karim

Keyword(s):

Cultural Diversity ◽

Ethnic Minority ◽

Healthcare Professionals ◽

Diversity Training ◽

Mental Healthcare ◽

Access To Services ◽

Gain Access

There is great concern about the access of ethnic minority clients to appropriate healthcare and the treatment they experience once they gain access to services. There have been recent calls for training in cultural diversity to be prioritised for mental healthcare professionals, including psychiatrists. In this article we discuss the term ‘cultural diversity’ and consider its relevance to psychiatrists. We then briefly review some of the training currently available, discussing related issues and problems, including the lack of evaluation. We suggest how psychiatrists may need to change their approach to this subject.

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Healthcare professionals’ descriptions of care experiences and actions when assessing postoperative pain - a critical incident technique analysis

Scandinavian Journal of Caring Sciences ◽

10.1111/scs.12308 ◽

2015 ◽

Vol 30 (4) ◽

pp. 802-812 ◽

Cited By ~ 3

Author(s):

Lotta Wikström ◽

Kerstin Eriksson ◽

Bengt Fridlund ◽

Kristofer Årestedt ◽

Anders Broström

Keyword(s):

Postoperative Pain ◽

Critical Incident ◽

Healthcare Professionals ◽

Critical Incident Technique ◽

Technique Analysis

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Preserved and violated dignity in surgical practice – nurses’ experiences

Nursing Ethics ◽

10.1177/0969733013498527 ◽

2013 ◽

Vol 21 (3) ◽

pp. 335-346 ◽

Cited By ~ 11

Author(s):

Lillemor Lindwall ◽

Iréne von Post

Keyword(s):

End Of Life ◽

Human Dignity ◽

Critical Incident ◽

Healthcare Professionals ◽

Critical Incident Technique ◽

Surgical Practice ◽

Practice Nurses ◽

Text Interpretation ◽

As If

The aim of this article was to obtain an understanding of what is experienced as human dignity by nurses in surgical practice. In order to obtain experiences from practice, the critical incident technique was chosen. A total of 11 nurses from surgical practice wrote 49 stories about positive and negative incidents. The text was analysed using hermeneutical text interpretation. The findings revealed patient dignity in terms of preserved dignity, that is, healthcare professionals paid attention to the patient. Nurses experienced preserved dignity when healthcare professionals allowed the patient to tell their story, allowed themselves to get close to the patient and in turn received the patient’s trust. Violated dignity included circumstances when the nurses were forced to see what they did not want to see. Nurses experienced violated dignity when healthcare professionals behaved rudely towards the patient, acted as if he or she was invisible or humiliated the patient at the end of life.

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Qualitative factors shaping MS patients’ experiences of infusible disease-modifying drugs: a critical incident technique analysis

BMJ Open ◽

10.1136/bmjopen-2020-037701 ◽

2020 ◽

Vol 10 (8) ◽

pp. e037701

Author(s):

Janni Lisander Larsen ◽

Jakob Schäfer ◽

Helle Hvilsted Nielsen ◽

Peter Vestergaard Rasmussen

Keyword(s):

Multiple Sclerosis ◽

Critical Incident ◽

Healthcare Professionals ◽

Disease Modifying Drugs ◽

Relapsing Remitting ◽

Disease Modifying ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis ◽

Infusion Regimen

ObjectiveTo explore factors shaping the experiences of patients with relapsing-remitting multiple sclerosis with infusible disease-modifying drugs in a hospital setting.Design and settingsThe critical incident technique served as a framework for collecting and analysing patients’ qualitative account practices involving infusible disease-modifying drugs. Data were collected through semistructured interviews and one single-case study. Participants were recruited from all five regions in Denmark. Inductive thematic analysis was used to identify and interpret factors shaping patients’ infusion journey over time.ParticipantsTwenty-two patients with relapsing-remitting multiple sclerosis receiving infusion with disease-modifying drugs (natalizumab, alemtuzumab and ocrelizumab).ResultsFour time scenarios—preinfusion, day of infusion, long-term infusion and switch of infusion—associated with the infusion of disease-modifying drugs were analysed to reveal how different factors could both positively and negatively affect patient experience. Time taken to make the treatment decision was affected by participants’ subjective perceptions of their disease activity; this may have set off a treatment dilemma in the event of a pressing need for treatment. Planning and routine made infusion practices manageable, but external and internal surroundings, including infusion room ambience and the quality of relationships with healthcare professionals and fellow patients, affected patients’ cognitive state and well-being irrespective of the infusion regimen. Switching the infusion regimen can reactivate worries akin to the preinfusion scenario.ConclusionThis study provides novel insight into the positive and negative factors that shape patients’ experience of infusion care practices. From a patient’s perspective, an infusion practice is not a solitary event in time but includes planning and routine which become an integral part of their multiple sclerosis management. The quality of space and the ambience of the infusion room, combined with the relationship with healthcare professionals and fellow patients, can be a significant source of knowledge and support people with relapsing-remitting multiple sclerosis in their experience of agency in life.

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